We are analyzing https://link.springer.com/article/10.1007/s00125-009-1440-6.

Title:
The influence of glucose-lowering therapies on cancer risk in type 2 diabetes | Diabetologia
Description:
Aims/hypothesis The risk of developing a range of solid tumours is increased in type 2 diabetes, and may be influenced by glucose-lowering therapies. We examined the risk of development of solid tumours in relation to treatment with oral agents, human insulin and insulin analogues. Methods This was a retrospective cohort study of people treated in UK general practices. Those included in the analysis developed diabetes >40 years of age, and started treatment with oral agents or insulin after 2000. A total of 62,809 patients were divided into four groups according to whether they received monotherapy with metformin or sulfonylurea, combined therapy (metformin plus sulfonylurea), or insulin. Insulin users were grouped according to treatment with insulin glargine, long-acting human insulin, biphasic analogue and human biphasic insulin. The outcome measures were progression to any solid tumour, or cancer of the breast, colon, pancreas or prostate. Confounding factors were accounted for using Cox proportional hazards models. Results Metformin monotherapy carried the lowest risk of cancer. In comparison, the adjusted HR was 1.08 (95% CI 0.96–1.21) for metformin plus sulfonylurea, 1.36 (95% CI 1.19–1.54) for sulfonylurea monotherapy, and 1.42 (95% CI 1.27–1.60) for insulin-based regimens. Adding metformin to insulin reduced progression to cancer (HR 0.54, 95% CI 0.43–0.66). The risk for those on basal human insulin alone vs insulin glargine alone was 1.24 (95% CI 0.90–1.70). Compared with metformin, insulin therapy increased the risk of colorectal (HR 1.69, 95% CI 1.23–2.33) or pancreatic cancer (HR 4.63, 95% CI 2.64–8.10), but did not influence the risk of breast or prostate cancer. Sulfonylureas were associated with a similar pattern of risk as insulin. Conclusions/interpretation Those on insulin or insulin secretagogues were more likely to develop solid cancers than those on metformin, and combination with metformin abolished most of this excess risk. Metformin use was associated with lower risk of cancer of the colon or pancreas, but did not affect the risk of breast or prostate cancer. Use of insulin analogues was not associated with increased cancer risk as compared with human insulin.
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Keywords {🔍}

cancer, insulin, risk, diabetes, metformin, patients, table, progression, monotherapy, solid, article, treatment, cohort, therapy, tumour, breast, sulfonylurea, google, scholar, type, therapies, cohorts, pubmed, people, cancers, human, general, analysis, study, years, prostate, cox, insulinbased, colorectal, increased, glargine, pancreatic, prior, baseline, model, cas, data, treated, proportional, hazards, regimens, combination, group, lines, tumours,

Topics {✒️}

full size image amp-activated protein kinase full size table alternative glucose-lowering therapies prior glucose-lowering therapy long-acting human insulin baseline cox model insulin–igf-1 signalling axis anti-cancer effects sufficient privacy choices/manage cookies clear dose–response association health improvement network diabetes-related products insulin-based therapies combined pharma research centre common treatment regimens alternative diabetes therapies insulin-based regimens specific insulin regimens main therapy classes health information network increased cancer-related mortality related subjects anti-cancer properties soedamah-muthu ss glucose-lowering therapies signaling pathways related insulin-based therapy insulin-treatment subcohorts insulin-based regimen tumour cell lines glucose-lowering medications european economic area kaplan–meier curve lewis jd margolis dj retrospective cohort study table 1 baseline characteristics table 2 baseline characteristics cancer-norfolk study oral regimen involving solid tumour cancers selected insulin subcohorts diabetes-related medication baseline general morbidity including eli lilly insulin-based therapies cox models develop solid cancers insulin–igf-1 series

Questions {❓}

Cazaniga M, Bonanni B, Guerrieri-Gonzaga A, Decensi A (2009) Is it time to test metformin in breast cancer trials?
Metformin and pancreatic cancer: Is there a role?

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